Technology to connect people

The greatest impacts on mental health have been seen among those groups most likely experiencing loneliness and social isolation prior to the pandemic. This includes young and older adults, persons living alone, people unemployed or on low incomes, and those with pre-existing mental health or other long term health conditions.

Here in the Western Isles of Scotland, we have high proportions of older people and persons living alone, which together with relatively low economic opportunities and rural mental health challenges potentially predispose our population to risk of loneliness and social isolation. Underpinning this is the islands’ geographical remoteness, such that technology has played a key role in supporting social connectedness. Therefore, when the pandemic arrived, the Western Isles was well placed to embrace the digital solutions that many were now turning to across the country. This was not without its challenges, as I had recognised following my Fellowship phase in Canada exploring how technology was helping address social isolation.

I work for NHS Western Isles and have a dual role leading both our small team of data analysts and a number of innovation projects in support of our organisations public health aims. The former has shown me the effects of social isolation on people’s health while the latter has given me the opportunity to test technological solutions including these described below.

When the Covid-19 pandemic arrived, I began to build on some of my earlier initiatives that focused on harnessing technology to aid social connectedness. This included the provision of personally tailored digital prescriptions to people, via our newly established Community Navigator service, which offered access to a range of common digital technologies for socially connecting (such as video-conferencing, social messaging and digital storytelling), as well as trialling some more innovative technology. One of those we tested was a solution called KOMP, which offered a one-stop digital hub providing a range of functions to assist persons with social connections, particularly those unfamiliar with technology. Deborah, the daughter of a user of KOMP, commented, “It was a very good tool… so I’ve setup a crowdfunding page to get more for the community,” and gave the example of her father using it for video call on his sister’s birthday when “she opened all her birthday presents with him... it meant so much to them.”

Another initiative was ‘Keeping in Touch’ (KiT), where we provided a ‘KiT technology trolley’ to island care homes, for use by residents who were experiencing severe social restrictions during lockdown. We ensured that residents were matched to suitable items and shown how to use them. The technology ranged from iPads to smartphones, to a more innovative ‘whzan’ product that we were testing with a developer, which discretely monitors a persons health and care needs for early signs of deterioration or change in behaviour (e.g. breathing, pulse, mobility ) and feeds this information back to residents’ carers and family.

As well as the improvements to people’s social isolation, we have seen benefits to their mental wellbeing, and our Community Navigators have extended support to assisting people with a range of computerised CBT programmes for anxiety, stress, sleep difficulties and more. Their support has been key in achieving improvements in levels of uptake and completion of these programmes.

Here are some key recommendations gained from my Fellowship and subsequent work before and during Covid-19:

• Harnessing and supporting the resilience of communities themselves, as they are often the source of many great ideas.
• The technology should be easy to use, no matter what complex systems and algorithms may be operating ‘under the bonnet’. Here the lessons from testing and trialling cannot be over-emphasised.
• Acknowledging that technology isn’t the silver bullet that will solve everyone’s challenges with social isolation. Including technology as a blended approach to improving social connectedness is important, with more traditional face-to-face interactions not being overlooked.
• It is useful to focus approaches in groups most affected by social isolation, as they will have some shared experiences and challenges in overcoming their difficulties, but not forgetting it can affect anyone anywhere.

I hope to continue my exploration of this area, with the second phase of my Fellowship in New Zealand post-Covid-19. Meanwhile I am encouraged that NHS Western Isles has a long-term commitment to supporting me in this work, via my participation in a number of international collaborations developing supportive technology. One of these is IT4Anxiety, which is working with potential users to develop new technologies that focus on alleviating anxiety - a big challenge during Covid-19. Another is ChatPal, a multi-lingual wellbeing chatbot service including support on loneliness, which we were able to release as a prototype during lockdown via app stores. The follow-up trials with our stakeholders will further refine this, and I am pleased that we are creating a unique Scots Gaelic version in response to the particular cultural context of our islands. Haidh, is mise ChatPal, do chatbot sunnd inntinneil!